Introduction:Oral Carcinomas being one of the most common cancers in India, surgery is the mainstay of management. Owing to the primary lesion or as a sequelae of radiation these patients often present with a difficult airway and pose a challenge to the Anaesthesiologist with respect to their intubation. The aim of this case report is to determine if Awake nasal intubation is a better and safer option for patients undergoing surgical resection of Oral carcinomas.Objective: To report a case of Awake nasal intubation in a patient undergoing wide local excision surgery of Buccal mucosa squamous cell carcinoma. Method: Search of relevant references from Pubmed, Elsevier and others with 15 considered relevant by authors were finally selected.Result: We present a case of a 40 years old female with a history of 20 years of tobacco chewing diagnosed with Left buccal mucosa squamous cell carcinoma who has undergone wide local excision of tumour under General Anaesthesia and was intubated awake, via the nasal route.Conclusion: We conclude that Awake nasal intubation is a safer alternative in patients with difficult airway, without the use of modern airway gadgets and peri-operative tracheostomy.Introduction:Oral Carcinomas being one of the most common cancers in India, surgery is the mainstay of management. Owing to the primary lesion or as a sequelae of radiation these patients often present with a difficult airway and pose a challenge to the Anaesthesiologist with respect to their intubation. The aim of this case report is to determine if Awake nasal intubation is a better and safer option for patients undergoing surgical resection of Oral carcinomas.Objective: To report a case of Awake nasal intubation in a patient undergoing wide local excision surgery of Buccal mucosa squamous cell carcinoma. Method: Search of relevant references from Pubmed, Elsevier and others with 15 considered relevant by authors were finally selected.Result: We present a case of a 40 years old female with a history of 20 years of tobacco chewing diagnosed with Left buccal mucosa squamous cell carcinoma who has undergone wide local excision of tumour under General Anaesthesia and was intubated awake, via the nasal route.Conclusion: We conclude that Awake nasal intubation is a safer alternative in patients with difficult airway, without the use of modern airway gadgets and peri-operative tracheostomy.